When doctors encounter a chronic disease, that tends to be where they put their focus - for example, to help an organ work more effectively or to reduce the severity of symptoms. For someone with arthritis, the focus may be on reducing pain and joint damage. For someone with heart disease, the main goal may be to ensure the heart receives steady blood flow and improve the person's ability to walk around.
What often doesn't get talked about as much is how to cope with the stress of living with a chronic disease. Living with the discomfort and inconvenience of a chronic disease can be stressful, and this stress in turn might affect the severity of the disease. A new study in the journal Frontline Gastroenterology, conducted by Swiss researchers, puts a spotlight on this fascinating topic.
The researchers recruited 597 people with Crohn's disease. They took a test that measured their level of post-traumatic stress disorder (PTSD) related to their Crohn's disease, and the researchers followed them for a year and a half. This disease causes inflammation in the digestive tract, which can occur at any point from the mouth to the rectum, though it usually affects the intestines. The condition can cause severe cramps, fatigue, pain, diarrhea, and weight loss. People with the condition may have to limit their diet and be ready to get to a restroom quickly. In short, Crohn's can have an impact on people's quality of life.
In the study, 88 people had a score on the test that suggested they had PTSD. Their odds of having a flare-up of the Crohn's disease were more than four times higher than people who had a lower score. Their odds were 13 times higher compared to the participants who scored zero on the test.
In light of these results, if you've been diagnosed with Crohn's disease, be sure to get treatment for any psychological issues that may be related to the disease in addition to treatment for your digestive system. Good questions to ask your doctor include:
• Could I be showing symptoms of stress related to this disease or other factors in my life?
• If so, could you recommend a mental health professional who focuses on people with chronic diseases?
• Is my Crohn's disease under control as well as it could or should be?
• If not, what can I do to help control it better?
• Can you direct me to a support group in my area for people with Crohn's or other chronic digestive diseases?
In addition, look to your own network of friends and loved ones for support. Can you lean on your family for more help around the house? Can you talk about your problems to an old friend when your burdens seem especially heavy?
One of my favorite methods of dealing with stress is a simple form of meditation called mindfulness meditation, which involves re-centering yourself in the present moment and directing your mind away from bothersome thoughts when they crop up. One resource that may be helpful is the book Full Catastrophe Living, by mindfulness guru Jon Kabat-Zinn, PhD, which is aimed at helping people cope better with illness. I am also a big fan of yoga as mind-body exercise. I find it very helpful for both relieving stress and providing tools for mindfulness (e.g. strategies for bringing the mind to the present, using your breathing patterns as tools to change your state of being). For more tips on managing -or preventing- chronic disease, my book The New Prescription will be available this May.

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